Udenrigsudvalget 2012-13
URU Alm.del Bilag 173
Offentligt
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Case Study
Ibtisam – Mother of a newborn in Zaatari refugee camp, Jordan

Child/Adult

Ibtisam (21), and her 1-week old daughter Dal’a. Isra’a Save the Children Jordan

Nutritional counselor.

Mother’s health, newborn’s health, Syrian refugees.

Themes

Summary

Interview conducted on February 18, 2013. A majority of the women that come to Save the Children’s Infant and youngchildren feeding caravans counseling are not aware of the benefits of exclusive breastfeeding, according to SuraAlsamman, Save the Children’s Jordan nutrition coordinator. Save the Children Jordan runs two centres in Zaatari refugeecamp where around 150 women visit come every day. Since the project started in December 2012, Save the Children hasreached around 2000 women. The centres are open 6 days a week from 9am -15pm and are women and children cetersonly. Save’s Nutritional educators and councellors have gone from caravan to caravan to introduce their services tomothers or mothers to be. Ibtisam’s husband is with her in the camp, he’s around the same age as her and this is theirfirst child, (although Ibtisam has had several miscarriages). Her brother is still back in Syria, she escaped with herhusband and sisters. Ibtisam does probably not represent an average, young Syrian mother because she has a nursingbackground. Ibtisam is getting folic acid and iron from the French hospital. Dala’a weighed 3,85 kg at birth, which is thenormal curve. Accordig to Isra’a, Save the Children Jordan’s nutrition expert, who is also Ibtisam’s counselor, says thatthe nutritional value of the food and the rations being served in the camp is OK but the simplicity of it and the same meals
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Case Studyover and over again people get enough fed up with Isra’a is currently seeing Ibtisam and her daughter once a week.

Ibtisam’s story in her own words

“I used to like the name Dala’a,” says Ibtisam about her one week old daughter, born on February 9, 2013 at 6.15pm in aFrench field hospital in Zaatari refugee camp. “We are doing fine. When I was in labour I thought of all those that I havelost, all those that have been killed, who kept asking me when my little Dala’a would enter this world, when she wouldcome to life. I closed my eyes and saw them all there in front of me. Immediately after Dala’a was born, I couldn’t takecare of her, I didn’t have the energy, I couldn’t take care of my daughter. But the following day I had gathered my strengthand could see her. Now, I am so happy I can’t even describe my feelings with words. Also because my husband is anorphan. So for us, this is the best gift ever, the best thing we could have wished for.”“The hardest thing of everything, being pregnant back in Syria and then coming here, was giving birth in the camp. I wantto give my daughter everything but I cannot because I am a refugee and live in a camp. Children here are deprived. Mynephew, 1 years old, who’s supposed to be taking his first steps but he is not because there is nothing to hold on to. Welive in tents. Children here get their first teeth later than they normally would. Some of the adults are loosing their teeth.The last time I ate was yesterday morning when I had breakfast. There is enough food (food rations provided by WFP,distributed every two weeks by Save the Children) but it is always the same, resulting in me not having much appetite.Now you can buy everything in the camp but you need money and at the moment we don’t have any. One egg will costyou 25 piasters JOD (0.35 USD as of 19.2.13). I try not to think too much about it if I am getting the right food in order tobe able to breastfeed properly. So far I haven’t had problems with it. Back in Syria I ate better and we had more food. Itwas expensive back in Dara’a but I was getting the right nutrition. Here we get rations.”“I’ve had four miscarriages, one of them was actually twins. Twice did I have a miscarriage after the war broke out. SoDala’a is my first child. The pregnancy was difficult, mostly because of my mental, and psychological state it was tough.My mother died in 2009 so she wasn’t around to see my first child.”“We left Syria and crossed the border on October 10 , 2013. Escaping from Syria was tough, I was in my 6 month ofpregnancy. We got support from the Free Syrian Army to cross the border, they drove me half the way, and then I walkedthe other half to cross. It was me, my husband and my sisters. Initially I didn’t want to leave Dara’a but my husbandconvinced me that we had to. He wanted this child so badly and it wasn’t safe any longer in Dara’a. Close to where wecrossed the border, there was a military base, so if they had seen or heard us, we would have been shot. I don’t knowwhat would have happened if we hadn’t left Syria. I might have ended up giving birth in the shelter. And in gods hands.There are no more clinics nor hospitals left in Syria.”“I was actually expecting to loose the baby. I have lost children before. But I was assisting other people back in Syria andhoped that God would allow me to keep this one. I have done nursing courses, five of them, but I always kept it as asecret, told my family that I was going to see my aunt. My last course was all about health in emergencies; how to stop anintense bleeding, how to treat bullet wounds and how to remove bullets from people’s bodies. I used to check up onpregnant women myself. I had been working as a volunteer with a doctor since the onset of the war. I even used to storesome of the medicine at my house in case the clinic would be attacked.”“After we arrived in Zaatari I went to the Moroccan hospital. I had had some infected water so I needed to be treated withmedication if my child was to make it. That also meant I had to lie down for a month.”“I used to get prenatal care. We have a family friend who’s a doctor and he used to check up on me. We did ordermedicine at some point but the injured always come first so we didn’t always get what we had ordered.”“I was actually wounded by sniper fire back in Syria. It hit me in the arm. I cleaned the wound myself and removed thebullet. My arm is fine now .”“Before I gave birth, I went three times to Save the Children’s Jordan IYCf centers for mothers and infants. Everyone inthe caravan was older than me. Most of the things I was taught I had known beforehand, but it was simply necessary forme to get it confirmed and to hear it from a professional. Now I for instance know how to deal with my baby immediatelyafter birth. And I also learned everything about exclusive breastfeeding. I did know that I was supposed to breastfeed fromthe very start. I was amazed though to hear how little some of the women knew about pregnancies and infants, it madethth
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Case Studyme laugh. There was this one lady who had fed her newborn with yoghurt and sugar and I told her she was committing acrime. The majority of people is not educated and doesn’t know those things. Then there were these friends of ours in thecamp (Zaatari) that we have befriended after we arrived. They have two children, an infant and a toddler and they madethem share a pacifier. At some point when no one was watching, I threw the pacifier away. It wasn’t hygienic to have themshare it. I am a very social person, I tell people, even if I don’t know them, that they are doing things wrong.”

Interview conducted by Hedinn Halldorsson, Red Barnet DK; during an assignment to Jordan in February 2013.

Scene-setting information

The interview takes place in the family’s tent in Street 6 in Zaatari camp. There is a single light bulb hanging in the tent’sceiling, there is a gas heater on the ground, four matresses and piles of blankets.

Project information and major issues

Save the children Jordan participated in the interagency rapid MUAC assessment for 845 children under 59 months ofage at the Zaatari camp in September 2012. Data on MUAC, presence/absence of edema, age, gender and presence ofillness was collected. The results indicated that nearly 50% of the children surveyed had been unwell with diarrhoea,upper respiratory infections or other illness within the reporting period, and that the rates of malnutrition were low. A keyrecommendation of the assessment was to “initiate preventive and nutrition promoting services such as IYCF andmicronutrient distribution. That is why two breastfeeding caravans were established to provide safe and calm areas formothers to breastfeed and to receive the right education and awareness about feeding for PLW and infants.Breastfeeding shawls were distributed to each pregnant and lactating woman (PLW) to ensure privacy and modesty whenbreastfeeding in the community. A team of breastfeeding counsellors and community mobilisers have been trained toprovide breastfeeding support and re-lactation counselling, in the community, the IYCF caravan(s) as well as the JHASclinic. Education sessions have been conducted by Nutrition Educators on maternal nutrition, infant and young childfeeding and other topics as requested by women. High energy snacks to PLW’s and children under 5, are beingdistributed, and water is also available in the caravan(s), as incentives for attending education sessions. A bottle‘amnesty’ is also being conducted from both caravans, with a suitable plastic cup being provided to each mother whoreturns a bottle that was given during a previous distribution. Advocacy activities including the promotion anddissemination of the BMS code, and attendance at coordination meetings are being carried out. Infant formula is currentlyonly available via prescription in Za’atari camp, after an assessment by the Midwife, at the JHAS/UNFPA clinic.
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